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PnH .. 'l'ctlin!,!s of the 2016 .. ( ; n·en Dcvclopmcn t In tern al ion a I Con Ie rcnce

tCiDIC 2016

The First Green Development International Conference The Indonesian international conference bringing together a local and world

community of scientists and engineers interested in recent developments on green energy and Technology

October, 25-26, 2016

Conference Chair Nazarudin, Ph.D

Editorial Reviewer Board Green Growth

Prof. Johni Najwan, S.H .• M.H., Ph.D Prof. Dr. Sahuri L. SH .• M.Hum Prof. Dr. Zulkifli Alamsyah Dr. dr. Herlambang , SpOG.KFM Dr. Hclrni, SH., MH Dr. lskandar Z. Siregar Rachel Carrnenta, Ph.D Prof. Dr. H. Syamsurizal Tan, SE, MA Dr. Ummi Kalsum, S.KM.,M.KM

Green Energy and Technology

Prof. Dr. H. RA Muthalib, M.S. Prof. Ors. Damris M, M .. Sc., Ph.D Prof. Erry Yulian Tri bias Adeta, M.Sc, Ph. D Dr. Jr. Ahmad Ridwan, M.Si Dr. Forst. Bambang lrawan, S.P.,M.Sc .. Ali Sophian, Ph.D Nazarudin, PhD Dr. Ir. Dharia Renate, M.Sc Dr. Mursalin, S.TP., M.Si Dr. Sal Prima Yudha, M.Si

Sustainable Agriculture

Prof. Dr. Abdul Azis, M.Si Prof. Dr. Ir. Hj. Adriani, M.Si Dr. Siti Herlinda Prof. Dr. Z Zulkarnain Dr.Agre. Teja Kasawari, M.Sc Prof.Adrizal, Ph.D Meine van Noordwijk, Ph.D Jesus C Fernandez, Ph.D Bambang Haryadi, Ph.D Dr. Sunarti, S.P., M.P Dr. Ardi Novra

Green Course Redesign with Technology

Prof. Dr. Muhammad Rusdi, S.Pd., M.Sc Prof. Dr.rer.nat. Rayanda Asyhar, M.Si. Dr. Supyan Hussin Aris Doyan, PhD Syahrial, Ph.D Hadiyanto,PhD Amirul Mukminin, PhD Jefri Marzal, Ph.D Eddy Haryanto, MSc.Ed., M.PP. PhD Siti Khanafiah, M.Sc

LEMBAGA PENELITIAN DAN PENGABDIAN KEPADA MASY ARAKAT

UNIVERSITAS JAMBI

The I 'st International Conference on Green Development - University or Iambi - 2016

Attitude and Sanitation of Canteen Related to Application of Food Hygiene Sanitation on Food Handlers in High School Canteen of

Jam bi City

Rina Fauziah1 and llmmi Kalsum! I Environment health dcpartcmcnt. Jamhi I lculth ot' Pol� technique, l11J1111csia

2 Public health study program, Faculty of Medicine anJ I kalth Scicncc.f lnivcrsily or Jam hi Email: tauziah.riuu'« �al111,>.f1>111

Abstract-Food handlers play an important role in food sanitation. Food handlers were a potential source of disun-uusing transferred to others through food. The aim of research to determine the relationship of knowledge, attitudes and sanitation of canteen with the application of sanitary hygiene of street food in the high school cafeteria in Jambi City. This research was observational which a cross sectional study design. Population and samples in this study were 104 food handlers. Collecting data .. using a questionnaire and checklist according Permenkes 942/Menkes/SKNll/2003. Data analysis using chi-square and multiple logistic regression at 95"/o confidence level. The results showed that 56.7"/o of respondents had a lower knowledge; 69.2% had a good attitude, 67.3% sanitation of canteen were not meet the health requirements. There were a relationship between knowledge (Odds Ratio (OR) = 3.359 (95% Cl: 1.477 to 7.640)), attitude (OR = 4.048 (95°/o Cl: 1.683 to 9.736)) and sanitation of canteen (OR = 4.038 (95% Cl: 1.701 to 9.586) ) with the application of sanitary hygiene of street food. The dominant factor affecting the application of sanitary hygiene of street food was a food handler attitude (OR = 4.899 (95"/e Cl: 1.814 to 13.227)) controlled by knowledge and sanitation of canteen. Attitude was a dominant factor on the application of sanitary hygiene of street food in the high school of cafeteria. So we need counseling, training and supervision regularly and continuously from Jambi City Health Office to the food handler and owner of a school cafeteria.

Keywords: attitude, sanitation, canteens, hygiene, snacks

I. INTRODUCTION

Health is a human need and a basic asset to live productively, useful and effective. One of the big influencing factors in our health is the environmental factor, behavior factor, health services and heredity. (Jambi Province Health Office, 2002:2). Environmen . really influences the quality of the food itself. T

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has a big potential in nutrition fulfillment and also has a level ol' , ulncrability which can cause ptomaine poisoning if it is 11111 based 1111 h) gicnc and sanitation, also a maximum guidance. (Candra. 2006: 12). Sanitation hygiene is an effort to control the tactors of food, people. places and equipment that can cause disease or illness. Diseases which arc caused hy food in environmentally based called Food Horne Disease. Food home diseases arc such as typhus, dysentery, diarrhea and ptomaine poisoning (Candra. 2006: 18).

Based on basic sanitation inspections result and the report of Jam hi City l lcalth Office (2013: 2) that there had been ptomaine poisoning such as chicken noodle in Kclurahan Sclarnat as many as 26 people. ptomaine poinsoning of gado-gado in Kclurahan Kasang Jaya as many as 11 people. ptomaine poisoning of Lontong in Kclurahan Simpang IV Sipin Tclanaipura as many as

13 people. and ptomaine poisoning of gado-gado in SMAN 6 Jarnbi as many as 19 people. In 2014. it also happened in Pondok Pcsantrcn Asad which caused ptomaine poisoning of Nasi bungkus as many as 18 people. in SMAN 8 Jarnbi as many as 24 people which caused ptomaine poisoning ofMie Ayam. and in SON (Elementary school) 27 as many as 15 people which caused ptomaine poisoning ofBubur Kacang Hija�.

Based on the basic survey who autho"� did in SMAN 6 and SMAN 8 Jambi that food handlers had not optimally implemented sanitation hygiene of street food, it was proved when the food handlers used a table napkin as dishtowels, when they took the food directly by hand without using forceps, when food handlers did not wash the dishes by using the running water, the dishes were gathered only in a basin and after washing the dishes, they just dried their hands by dusting to their clothes, also the food was opened to the air. The author also made observations about the garbage in the cafeteria around the canteen that there was still scattered and the garbage cans were not covered, sewerage did not flow smoothly. The result

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The I "st lnternational Conference on Green Development - University of Jambi - 2016

of' author's interviewing with the: food handlers that there 111.·n: 1111 supervision, they were Olli controlled and trained h) Jarnbi Ci Ly I lealrh Olfa·c about the upplicution nf sanitary h� gicnc ul' lood in the: school canteen.

The research which was Jone: by Agustina (2009:Kl 111 the: extraordinary events I K LB) of food borne: disease showed that the disease was bused on the environment. \\ hich was caused by not applying the sanitary hygiene of foou. so the food was contaminated. The good sanitation hygiene of food needed tu be supported b) the en, ironrncnt condition and supervision hy the I lcalth Office and the school 10 the meet foods which were sold in the school canteens. Hcsides that. it needed to he supported hy the knowledge and good attitude uf the food handlers in applying of hygiene sanitation of foods which were sold in canteens.

The: research which was done: by Budiyono 12008:8) that then: was a significant relationship between the level of knowledge and practices of food handlers about hygiene: and sanitation of food al eatery in Central Jakarta, which meant that the knowledge played an important rule on the quality of the food. Research which was done by Naria C2015: 7) on hygiene sanitation of food and beverage in USU complex, Medan said that traders who qualified as a whole in implementing the six principles of sanitary hygiene of food and drink as much as 69%.

A successful application of sanitary hygiene of street food besides from the high level of knowledge, it also needs lo be supported with a good attitude. Base on the research above that behavior and environmental factors played an important role on lhe quality of the food. Factors that influenced behavior change were knowledge, attitudes and actions. factors that influenced the behavior change consisted of knowledge and attitude. The environmental factor was canteen sanitation, while the application of sanitary hygiene was an affected factor.

Based on the results of previous studies and inspections of basic sanitation was done by Jarnbi city Health Office and the basic survey who author did, so it needed to do a research on the interaction of knowledge, attitudes and sanitation canteen with the application of sanitation hygiene of street food by food handlers in the high school cafeteria in Jambi City in order to avoid ptomaine poisoning that harm consumers and students.

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II. Mlffl\Ol>S

This research \\JS observational with cross sectional MuJy which the authors understand the interaction of independent variables anJ the dependent variables were done al the same time (N11tuaJmoJj11. ::!005: 3:?). The aim of research was 10 determine the relationship of know ledge. attitudes and sanitation of canteen with the application of sanitary hygiene of street food in the: high school cafeteria in Jambi City. This research was conducted in high school cafeteria in Jambi cit) on August until October 2015. Population and samples in this study wen: I n-t food handlers in high school cafeteria in Jambi city. The instruments used in this study wen: questionnaire for the interviews and check! isl for observation.

Ill. RESULT

Univariate Analysis

The frequency distribution pictures of knowledge. attitude and canteen sanitation with the application of sanitary hygiene of street food.

The knowledge of food handlers were grouped into two categories: high and low knowledge. The attitude of food handlers were grouped into two categories of good :md bad. The canteen sanitations were grouped into two categories of eligible and ineligible. The frequency distribution of knowledge attitude and sanitation canteen can be seen in Table I.

Table I. Frequency Distribution of Knowledge, Attitude, Canteen Sanitation and application of hygiene sanitary of street food

No Variable Total Percentage %

I. Knowledge - High 45 43,3 - Low 59 56,7

2. Attitude - Good 32 30,8 - Bad 72 69,2

3. Canteen Sanitation - Eligible 34 32,7 - Ineligible 70 67,3

The 1 'st International Conference on Green Development - University of Jambi - 2016

BIVARIATE ANALYSIS

BIVARII\TE analysis was used to determine whether there was a relationship between the independent variables with the dependent variable. The relationship of knowledge. attitudes and canteen sanitation and the application of sanitary hygiene of street food by food handlers in high school cafeteria Jambi city can be found in Table 2.

Based un Table I. it could be found that the low knowledge or food handlers was 59 (56.7%). more than the high knowledge. The bad attitude of food handlers was 72 (69.2%). more than the good attitude of food handlers. The ineligible canteen sanitation was 70 (67.3%). more than the eligible canteen sanitation. The bad application of hygiene sanitary of street food was 63 (60.6%). more than the good application or hygiene sanitary of street food.

Table 2. Knowledge interaction, Attitude and Canteen Sanitation and Application of Sanitary

Hygiene of Street Food

P- Value 0,003 0,001 0.001

G

08,696 10,222 10,494

130,790 129,264 128,992

Log­ Likelihood

Variable

Knowledge Attitude Canteen Sanitation

I 2 3

Number

Multivariate analysis was used lo determine which independent variables were most connected to the dependent variable. In this study the authors used multivariate analysis types Multiple Logistic Regression was one of the approaching way which used a mathematical model lo analyze the relationship between several independent variables with the dependent variables,

Table 3. lnteraction Analysis Results Between Knowledge. Attitude And Canteen Sanitation with the Application of Sanitary Hygiene of Street Food

MULTIVARIATE ANALYSIS

Based on Table 3, it could be found that there were three variables that p-value <0.05, those were the knowledge variables with p-value of 0.003, the altitude variables with p-value of 0.001, and the sanitation canteen with a p-value of 0.00 I, thus all the variables entered into the multivariate model.

between tho: kno» ledge 111' lood handlers anJ the application 11r sanitary hygiene 11f street food. The good uuitude or food handlers and the application of sanitai: h) gicnc of street li111J were 20 (62.5%). the bad attitude of loud handlers and the bad application of sanitary hygiene or street tood were 51 (70.8%). Statistical test results obtained p-vulue 0.003 ,0.05 means that there "as an interaction between the attitude of food handlers and the application of sanitary h) gicne 111' street food in high school cafeteria in Jarnbi City. The Legible canteen sanitation and the application of sanitary hygiene of street food were 21 (61.8%). and the illegible sanitation canteen and the had application or sanitary h) gicne of food were 50 ( 71.4%). Statistical test results obtained p-value 0.002 <0.05 means that there was an interaction between sanitation hygiene canteen with the application of sanitary hygiene of food in high school cafeteria in Jarnbi City.

p.

0,00 3

0,00 6

Val»

3<JA 60.6

Total

63 .ti

% To % Total % � tal

61,8 13 38,2 34 10 0,00 0 2

28,6 so 71,4 70 10 0

Application orSanilary Hygl�M or Strttl Food

Good Bad

25 SS,6 20 44,4 45 10 0

16 27,1 43 72.9 59 10 0

20 62,S 12 37,S 32 10 0

21 29,2 SI 70,8 72 10 0

Application or I lygienc Sanitary or Food - Good - Bad

Variable

4.

lnleaible 20

- Bad

Total

Canteen Sanitatio n 21 - Legible

Knowled ge - High

- Low

Attitude - Good

Based on Table 2, the high knowledge of food handlers and the good application of sanitary hygiene were 25 (55.6%), and low knowledge of food handlers and the bad application of sanitary hygiene of street food were 43 (72.9%). Statistical test results obtained p-value 0.006 <0.05 means that there was an interaction

IV. DISCUSSION

The interaction of knowledge with the application of sanitary hygiene of street food, in this study there were more low knowledge food handlers compared with high knowledge food handlers. It showed that

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knowledg�· or fo.xiJ handlers sining!� supported _the applic;iti,in or sanitary hygiene or Flllld. Multi, arratc analysis result II ith logistic regression that the knowledge variuhlc tested together with the altitude variable and canteen sanitation variable gave a signilicanl contribution to the application of food_ hygiene sanitation. This is indicated by the number ol OR 3,429.

The° research which was done by Yunacnah (2009:48) stated that 64% of food handlers who did not use the tools or damp while taking food had a potential of contamination.

The results or the study showed that the low knowledge or food handlers was the food handlers at SMAN 2 (42.5%). SMAN 6 (34.5%). and SMAN 7 (25. 7% ). The low Knowledge of food handlers was because most or them got low education. The education or food handlers <High schools wen: 81 (77.8%). and also there were no training, counseling and supervision by I lealth Office of Jambi.

Based on Rahrnawatis Research. (2015: 52) that the action was based on the knowledge would be better than the actions that were not based on knowledge. where the correlation between knowledge and attitude of food handlers about hygiene. food sanitation and practices or Pcnyet food handlers in T crnbalang Semarang were not good with the score of knowledge 52% and 64% for altitude.

The results or the bivariate analysis with chisquare showed that then: was an interaction between the food handlers attitude and the application or sanitary hygiene or food in high schools cafeteria in Jambi city with a significant value of 0.003 (p <0.05). The application of good hygiene sanitation was more common the bad attitude as many as 51, than a good attitude as many as 12.

The result of Multivariate analysis with double logistic regression, that the attitude of food handlers were tested together with knowledge of variables and canteen sanitation gave a significant contribution. lo the application of sanitary hygiene in high school cafeteria in Jambi City, even it was the most dominant variable. It was proved by the numbers OR was greater than the other variable is 4.899.

The results showed that the bad food handlers attitude were in the cafeteria SMAN 6 (4%), SMAN 1 (7.8%), and SMAN 8 (7.5%). The bad food handlers attitude is one of the reason, because when the author was

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doine this research. Jumbi cit) was in drought at that time: so fo11d handlers did not apply the principles nr sani1;11: hygiene or food. the water was hard lo linJ so the tood handlers washed their dishes" ith a minimum amount of water and II hen serving the food, they did not think about the principles of sanitary hygiene because there were no training. counseling and supervision by l lcalth Ollice or Jamhi. Besides that, a crowded student in rest time madc the food handlers could not serve the food by applying the principles of sanitary hygiene. They just thought how 10 sell all their foods.

Altitude is a tendency 10 respond positively or negatively to thc organism. object or situation (Sarwono. 2007: 36). Attitude is not an activity but a predisposing of behavior formation (Notoadmodjo. 2007: 64). The expressing attitude also is somcthing that is influenced bv the surrounding circumstances. while the expressing attitude is a behavior. Behaviors and attitudes interact and inllucncc each other (Walgito. 2004: 40).

A positive attitude in the value: or health. were not always implemented into a concrete actions. Attitudes would become a real action was needed a supporting factor or a possible condition such as information. facilities and supporting factors of various parties (Notoadrnodjo. 2007: 65). It means that the altitude is shown by the food handlers would not produce good results if the whole party can not support each others.

It fits with research Wagustina (2013: 8) stated that there was an inlluence of hygiene and sanitation training to the knowledge and behavior of food handlers with a percentage of 76%. Domain knowledge was very important for the formation of a person's actions. The action was based on the knowledge would be longer than the action that was not based on the knowledge (Maria, 2011: 15).

The interaction of canteen sanitation with the application of sanitary hygiene of street food, in this study there were more eligible canteen sanitation than the legible. Interaction with the application of sanitary hygiene of food sanitation accepted statistical p-value of 0.002 (p <0.05). It showed a support to the application of sanitary hygiene of food.

Research shows that the bad canteen sanitations were SMAN 2 (40.7%), SMAN 5 (32.4%), and SMAN 6 (33.3%). Based on interviews and observations, showed that the water sources in the high school in Jambi City were from PDAM, wells and boreholes/

The 1 'st International Conference on Green Development - University of Iambi - 2016

The I 'st International Conference on Green Development - University or Jambi - 2016

Artesian well (Allachmenl I J. Willer parameters were observed in this study arc the parameters of physical Willer (water is tasteless. odorless and colorless) based Pcrmcnkes 416 I Menkes I PER I IX I 1990 About Conditions and Water Quality Monitoring. Providing the dean water in SMAN 2. SM/\N 6, SMJ\N 7 and SMAN 8 Jambi were less qualiflcd in physically because the water color is yellow and smelling. The amount of water in high school in Jarnbi city also was n:I) minimal. because when the author was doing this research, Jambl city was in drought and smog at that time. PDAM water source was stopping. the well was dry, so lhe water was not enough and in 11 small amount. The food handlers washed their dishes h} using minimum water in order that the water was enough for the other canteen's need. Unavailable waler also affected Toilet/WC in the schools, WC conditions were not maintained cleanliness of their envirortrnent and caused a bad odor. To overcome this problem. school bought water by using the cistern for their daily needs.

Clean water is the water that is used for everyday purposes. As the limit. clean waler is water that qualifies the requirements for drinking water supply system. Wibawa, A Research (2008: 14) stated that to support the application of sanitary hygiene of street food is the availability of sanitary facilities. Results showed that the sewerage at SMAN 2, SMAN 6 and SMAN 7 Jambi was not qualified, this was because of a pile of garbage around the: disposal of the waste. so the waste water clogged and did not llow smoothly, and sewerage was very close to the neighborhood canteen so that the environment canteen often caused a bad odor. this could lead to breeding grounds for the nuisance vector and polluted the environment around the cafeteria. How to solve the problem, the garbage piled around the disposal or waste water was collected and disposed from the place so that waste water could flow smoothly. Waste water was the remainder or a business or activity that was in liquid form. Wastewater could be derived from household and industrial.

The sanitary facilities were the tools and equipments that must be available to maintain the quality or the environment or the controlling factors of the physical environment that can lead to contamination of the food or the surrounding environment, in addition to wastewater sanitation facilities were also needed such as the availability of waterproof bins, did not rust and closed. The Waste from the school canteens of SMA N 2, SMA N 6, SMA N 7 and SMA N 11 were thrown

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in the trash \\ hich \\ as used ll• uccununodatc the trash did not correspond to the amount of waste, cans were not closed anJ strewn around the canteen, there were n11 special personnel garbage, waste \\ as Jisp\lscd directly hy the li�,d handlers ilt the lime aflcr selling. but taking out the trash when finished sctling was not routinely curried out h) folld handlers. This could damage ibe environment around the cafeteria and cause insects such as rats. cockroaches llied around and alighted on the food. so if consumers ate and used the utensils that could cause ptomaine poisoning, causing health problems and polluted the environment around the cafeteria. I low to overcome this trash could he made a lot o]' larger hins to accommodate the amount of the wa. s te and 10 prevent the entry of animals and caused had odor. Garbage should be disposed every da� so to prevent environmental pollution caused hy garbage,

Results (If Santoso, trs research (2003: 8) stated that wastewater was a highly supportive factor cafeteria atmosphere, if the cafeteria near by the sewerage would cause the unpleasant smell and very disturbed consumers who ate in the cafeteria.

Base on the research that school canteens were not qualified because there were not appl) ing the sanitary hygiene of street food, lack of sanitation facilities, no training, no counseling and supervision by I lealth Office or Jarnbi, While the ma)or of Jambi programmed a healthy school and one of the indicators is the school cafeteria, /\ healthy school is a school that has sanitation such as dean waler. sewerage that runs smoothly and flows, availability of toilet I WC. availability of bins are waterproof and have the lid as well as the availability of hand washing facilities. Hand washing facilities were available only in SMA I, SMA Negeri 3, SMA Negeri 4 and SMA Negeri 5 but hand washing facilities were not well maintained, there were dirt bins in place of hand washing, container washstand looked dirty and there were larvae, except in SMAN I and SMAN 4 hand washing facilities provided in the form of small size tedmon surrounded tedmon mounted faucet for hand washing, the students wash hands with running water and soap and hand wipes also available. Hand-washing facilities could also be a learning tool to get a clean life, to get used lo wash hands with soap and running water food handlers, the panel of teachers and students would have a clean and healthy living habits. This is same with Sulernah's research (2008: 38) stated that the relationship between canteen sanitation with physical place of food processing in University of'Indonesia did

The I 'st I nternational Conference on Green Development - University of Jarnbi - 2016

not lJllali(\ at 56% and the reason was because no supervision to canteen in University or lndoncsia.

Nurtika's Research (::?011: 8) stated that food handlers played an important rule in canteen sanitation. where the condition 1lf canteen sanitation were eligible besides tho: avuilubility of tacilhics. auuudcs or behavior of rood handlers played an important rule in the school cafeteria.

Multivariate anal) sis results obtained odds ratio (OR) of variable attitude \\JS -1.899 (95% Cl: 1.814 to I 3.2::?7) means the attitude variables have the possibility ot'thc bad Application of Sanitary hygiene 5 times alter the controlled variable knowledge and en, irunmcntal sanitation canteen. The analysis showed that the attitude was the most dominant variable interacts with the application t1f sanitUI) hygiene or fond handlers in high school cafeteria in Jambi city with OR greater than other variables, 4.899.

supervision and guidance to Iood handlers s11 we can create healthy school canteens, For Educational Departments arc expected lo support the cm ironrncntal sanitation conditions of school canteen and issue policies that essentially supports environmental sanitation healthy school canteen and the school is also expected to evaluate the implementation of existing policies. As a policy holder. the school can work with the Jambi City I lcalth Office and Bl'OM in controlling and giving supervision to the school cafeteria. For Other authors expected to add variable linancing. policies. culture and internal characteristics. so thal we can know more about the factors lhal have an interaction with the application of sanitary hygiene of food and could he added the students as a research objects. Food bandlcrs arc expected 10 apply the s:initUI) hygiene of foods which arc sold to guarantee the health of students and can create an environment of healthy school canteen.

According lo Notoadrnodjo (2007: SJ) attitude is a reaction or response to someone who is still closed to a stimulus or object. Attitudes are the real show their connotation of conformity reaction to certain stimuli. A good knowledge becomes bad if it is not followed by a good attitude. It means that although the knowledge of food handlers on the application or sanitary hygiene or food is good, if it is not implemented with a good attitude then there will be no meaning.

V. CONCLUSIONS

The conclusion of this research, there is a knowledge interaction with the application of sanitary hygiene or street food. where the low knowledge offood handlers was 59 (56.7%) with a P - value 0.006 and OR value <1f 3.429. There is an attitude interaction with the application of sanitary hygiene of street food, where the bad attitude of food handlers was 72 (69.2%) with a p • value 0,003 and OR value of 4.899. There is a canteen sanitation interaction with the application of sanitary hygiene of street food, where illegible canteen sanitation 70 (67.3%) with a p vvalue of0.002 and OR value of 3.090. There is a dominant factor that interacts with the application of canteen sanitary hygiene is the altitude with OR of 4.899, after being controlled by (95o/o Cl: 1.814 to 13.227).

Suggestions for Government agencies (Jambi City Health Office and Department of Education & Culture Jambi) are expected to develop healthy school, compiling SOP, doing a promotion, training,

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The I "st International Conference on Green Development - University of Jambi • 2016

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